Walgreens #04409
LBN: Walgreen Co
Walgreens #04409 is an health care organization with primary practice located at 1713 W Springfield Ave , Champaign IL 61821-3011. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Walgreen Co can be contacted via phone (217) 356-2529, or through Taylor, Kira L via phone (217) 709-2351.
Contact Information
Primary practice address
1713 W Springfield Ave
Champaign IL 61821-3011
Phone: (217) 356-2529
Fax: (217) 356-1423
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | 54004035 | Illinois |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1689689705 |
|---|---|
| LBN Legal business name | Walgreen Co |
| DBA Doing business as | Walgreens #04409 |
| Authorized official | Taylor, Kira L |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jul 29th, 2006 |
| Last updated | Apr 4th, 2022 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689689705 | NPPES |
| Illinois | MEDICAID | 362127039094 | |
| Illinois | Other | 1401897 |
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